fallout

It is standard policy in my area to respond emergency traffic to any call except public assists.

Given the dense nature of our streets and the dense nature of housing, we tend to run lights only and just be vigilant about clearing intersections. We use the siren as conditions dictate, usually to get on the few main thoroughfares in town or when there is heavy traffic.

Regarding slow driving, I've only known one person to get talked to about it, but it was somewhat warranted. They were going 30 mph in a 50 mph zone, no real traffic congestion while a multi-system trauma was exsanguinating.

In regards to emergency traffic, it is reserved for strictly time-critical scenarios such as MI, CVA, any life-threatening surgical case or any situation where the is genuine loss of quality of life (or loss of life) for not receiving rapid intervention on the level of a hospital. The emphasis, however, is on getting there in one piece without throwing people around in the back. I don't really see emergency driving as screaming to the ER risking life and limb, as some at EMTCity describe it. It is a technique of driving, that with experience and training, can be done safely.

I have never seen paramedicine as a "stepping stone" to medical school, if you will. I ended up in the profession, by accident in a way and realized that I enjoy emergency prehospital medicine, but that I also find some aspects of medicine as a whole fascinating.

During my paramedic clinicals, I have had the opportunity to observe several surgeries and spend time observing cath lab procedures, as well as spend time in Cardiac ICU's. I found that experience to be what truly piqued my interest. Paramedicine is interesting, but other forms of medicine are more interesting, at least to me.

I have written a plan that has the potential to end up in medical school in addition to leaving me a way to go to other professions in medicine, if I so choose. I realized that I needed to shift my end career goal when I had a school preceptor get angry at me for viewing x-rays and lab values in an attempt to form a better diagnosis of the patient's condition. I was told it is "too complicated" for paramedicine.

Anyway, I see it something I have to take a day at a time.

I find it suprising that this is an extensive debate.

From a SOG perspective, we don't transport if the following criteria are met:

1.) The patient begins or rapidly deteriorated into asystole.

2.) The patient has adequate airway management and appropriate ALS drug therapy has been applied.

3.) No spontaneous return of circulation.

4.) The origin of the code is non-traumatic.

5.) Family members support field termination of the code.

One service going to extremes to avoid a > 8 minute response time?

It was just a joke. Trying to inject some levity and all that.

Retired police horses...good choice my friend!

I was on my way to the call lights and whinny when my horse blew out a knee. We had to call another horse team for him and send another to respond to the accident. If only we had bought new horses D:

On every call I bring my airway bag and AED as a bare minimum.

If I have any significant distance to the scene, e.g. stairs, elevators, long walk everything comes, Monitor/AED (based on if it's lil old me or a paramedic is with me), ALS bag and airway bag. I was burned on running to the truck for stuff on one call and I'll never forget it.

One of our part-timers was caught by the county sheriff having sex with a prostitute.

The best part?

He had just gotten off duty.

He started waving his uniform shirt out the window hoping the sheriff would go away.

He can't work that station anymore, because the sheriff said "I never want to see you in this town again."

He has a wife and kids at home.

He didn't get fired.

It really is mind-boggling the stupid stuff people pull.

Rebel Medic reminds me of a certain former forum member who liked to make his point with tons of graphics interspersed with research studies.

I'm going to get a tattoo of the day my ambulance slipped into reverse and drove across the ambulance bay.

Unit 66158-You were a heck of a "Dear chief" letter. We will never forget. 08/17/05

But BLS is about critical thinking, anatomy, and physiology. Anybody who doesn't see this just doesn't get it.

That is what BLS should be about. Unfortunately, not everyone sees it that way. I know my class jumped over tons of anatomy just to get to the ever exciting skills. Not saying it is right, just saying how it goes. It did better on the critical thinking side, but critical thinking without adequate background is guessing.

This is entertaining just to read you guys!!

I have been a Specialist for almost 2 years and will be a Medic as soon as I get my results back, so I was a newbie EMT at one time....just remember...don't move on to another level without being a GOOD basic first. I think everyone should be a basic for at least 2 years before becoming a Medic. Good Medics are always excellent basics first...

As has been said many a time around here, no other medical profession requires one to be a LVN before a RN or a RN before a physician. Why should prehospital medicine? I really can't see anyone with any brains taking two years to learn to do what a basic does in terms of medical care, which is essentially put patient on backboard, apply oxygen via some appropriate method and get to a hospital or drive to ALS intercept.

It is important to have a handle on the fundamentals of patient treatment, but two years? Some go from joe off the street to RN in that amount of time.

This thread is becoming ridiculous.

We are in a time period where EMS is struggling to adapt to new roles and find it's place within the greater medical community.

Yet, here we are, arguing about the important stuff, like badges.

You shouldn't ever come into the situation of not having your truck clean when you get on scene. The truck should be cleaned before you are back in service.

I said clean the truck after the call, trying to avoid the inservice with a messed up truck scenario. In the ideal world, that happens, but I've been on duty some days where there are 5 or 6 911 calls holding. At that point, it turns into screw it, no blood around? Is the equipment that will be used in a servicable condition? Alright, let's go.

This also shouldn't be done in "downtime". This should be done at the hospital, when you are cleaning the truck, BEFORE you are back in service.

Not every service stocks out of the hospital. We stock out of our station. I'm not going out of service because I'm down a bag of saline, an 18 gauge and 30 cc syringe.

Yeah, and I have basic skills like tying my shoe laces and brushing my teeth. No one makes a T-shirt about doing that, although with some EMT's I have met, dental hygiene should be reinforced about as much as basic skills should.

Hey, I have a certificate on my wall, certified shoe tier and tooth brusher. I ordered a t-shirt even. Certified tooth brushers save EMT's! I'm very proud of it.

Tactical underwater flight EMT?

Well, the new lines of torpedoes "fly" underwater so it shouldn't take much to squeeze the air from between an EMT's ears to create the pocket of air to "fly" on.

From someone who is a fairly new EMT (1 year experience) in an ALS system.

Once the patient is off the stretcher, and if you weren't the attendant, get the stretcher and yourself out of the ER. They are busy places and don't really need random junk around.

Clean the truck up after the call. Nothing is worse than catching a call in the ER dock and having the truck a mess when you get on scene.

When you have downtime, restock everything you used.

If you don't know about something, ask the incharge on your ambulance. Not reading their mind is ok, not asking when you can't isn't.

Know how to spike a bag correctly.

Know how to pull up a saline flush and set up a lock.

Understand the basics of the monitor. No one is asking you to set up a pacer or anything, but know how to attach the multi-function pads, know how to print out strips, turn the thing on, etc.

Err on the side of caution. If you see something that doesn't seem safe, say so. I'd rather have my partner overcautious and healthy than apathetic and hurt.

If you work for a medium-sized city service, like I do, we call on our primary to dispatch for PD and then they relay the call to PD. It seems silly, but it keeps things organized.

For the record, I suggested using a band saw to remove the patient's hand. Give credit where credit is due.

It may have been the oxygen, I believe I read a release of some defibrillator sparking and igniting lingering oxygen.

Nitroglycerin was once the most volative explosives mankind had, until Alfred Noble discovered it could be mixed with an inert binding agent, resulting in dynamite.

Medical nitro is only .4 % actual nitro, the rest is an inert binding agent. Consequently, under almost all conditions short of being dropped in a furnace, it cannot explode.

I've been at some services where when doing a 12 lead, they use a hospital gown for patient dignity and ease of access. Other than that, no.

As a paramedic student, I have always been told "BLS before ALS." but my educators made it very clear that they meant start with the least invasive/least risky procedure and proceed to the more risky procedures given the patient's response. Some things clearly call for aggressive ALS management e.g. cardiogenic shock. Other things, such as respiratory distress, general practice is to start with oxygen delivery and CPAP or PPV before going to medications and the potential side effects.

Maybe "Initiate solid BLS management as a temporary measure until definitive ALS management can be performed."

Hardly a slogan to inspire the youth of America, but I'm not in marketing, so who cares.

Personally, I just call the fire department and have them use the band saw on it.

Sure, we may take off the patient's hand in the process, but damn it, that ring will be cut.

Hey, I heard that if you drop a bottle of nitro spray, it will blow a crater the size of a football field! Is this true??

By the way, if you forward this to everybody in your address book in the next fifteen minutes, Bill Gates will give you a free computer!!

I dropped a crate of the stuff the other day, took out the station and set a city block on fire. True story.